Ebola outbreak demands 'action in the field,' MSF's Joanne Liu warns

Medical groups such as the World Health Organization and Doctors Without Borders are calling for more health-care boots on the ground, and some Canadians are answering.

The Ebola virus outbreak in West Africa has led to a total of 2,473 cases and 1,350 deaths in Guinea, Liberia, Sierra Leone and Nigeria as of Aug. 18, according to the World Health Organization.

"Some clinics are seeing in one day the number of cases and deaths that we saw for entire countries in previous outbreaks," said Nyka Alexander, WHO spokesperson in Conakry, Guinea.

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Most infections in Liberia, Guinea and Sierra Leone are taking place in the community when family members or friends take care of someone who is ill or when funeral preparation and burial ceremonies do not follow strict infection prevention and control measures, the UN health agency said earlier this week. 

Clinics and other health-care settings where people have unprotected contact with a person who is infected are another source of transmission.

More mobile hospitals are needed, but the most immediate need is for people who have experience and can work on Ebola, Alexander said.

"You can have an expert clinician but if they've never worked in Ebola before, they might hurt themselves more than helping others."

WHO has called the Ebola outbreak a "public health emergency of international concern," but that’s not enough, said Canadian Dr. Joanne Liu, international head of Doctors Without Borders.

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"We know no statement has saved lives in the past unless it’s followed up by concrete action. We need action in the field right now," Liu said in an interview Wednesday with David Common, guest host of CBC-TV’s The National.

"It's not by barricading ourselves in our home country that will make a difference. What will make a difference to prevent a global threat for the rest of the planet is to contain it regionally by bringing more capacity in the field," Liu said.

Anthony Twyman is an infection control practitioner at the Toronto Western Hospital. Four weeks ago, he saw WHO’s urgent appeal for people with his skills. Twyman applied, was interviewed and now there’s a frustrating "radio silence" while he waits for news of his deployment.

"I'm going to put aside what I believe to be nerves and reassure myself if I understand what I'm doing, I can do this safely and … be part of the efforts to actually control this," said Twyman.

Twyman doesn’t know where or when he’ll be deployed. Previously, he’s worked in Senegal.

He said he’ll use best practices in infection prevention and control for Ebola virus, which includes wearing a biohazard suit and taking precautions when entering a ward where there might be diarrhea and vomiting that may occur in the first few days of infection. "You don’t want to be a vector for transmission."

Weeks ago, University of Toronto immunology Prof. Eleanor Fish reached out to WHO with a treatment idea that she believes should be considered to help Ebola patients. Fish tested first interferon during the 2003 SARS outbreak, and the drug is now approved for clinical use worldwide against hepatitis C infection.

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"I have been invited to join a working group organized through the World Health Organization that is specifically looking at potential therapies to be used during this outbreak," Fish said.

Alexander said WHO has about 130 people who are on the ground in the three most affected countries of Guinea, Sierra Leone and Liberia, adding that since the beginning of the outbreak, about 400 people have been actively working there.